Giant right atrial Myxoma associated with acute coronary syndrome

Primary cardiac tumors are extremely rare. Myxomas are the most common, typically affecting middle-aged women. They arise in the left atrium in 75% of cases. Right atrial myxomas are less common. The coexistence of coronary artery disease is rare but can be complex. We report the case of an 80-year-old male smoker with peripheral arterial disease and stable angina, who was diagnosed with a right atrial mass seven years earlier but initially declined surgery due to fear of the procedure. He was admitted to our hospital with crescendo angina. Echocardiography revealed a large right atrial mass suggestive of myxoma. Coronary angiography demonstrated severe multi-vessel atherosclerotic coronary artery disease, including mid circumflex occlusion. After successful balloon angioplasty, he underwent combined myxoma resection and coronary artery bypass grafting. This case illustrates the uncommon but serious combination of myxoma and acute coronary syndrome, reinforcing the need for careful surgical planning to achieve a favorable outcome.